What to expect
Your initial physiotherapy visit and diagnosis
At your first consultation the Physiotherapist will take a detailed medical history, including information about your lifestyle such as your level of physical activity and your work environment, together with any relevant past medical history. In order to ensure a long-term physiotherapy program to address your problem the Physiotherapist will be just as interested in what is causing your problem as the effect it is having on your health. For example, is your shoulder condition caused by a rotator cuff lesion from playing sport or lifting the shopping or is there another cause, such as referred pain from a tight muscle in the neck caused by sitting for hours driving or in front of a computer.?
After your history has been taken the Physiotherapist will examine how you move. You may be asked to remove some of your clothing (it is helpful if you are able to attend the visit in gym clothes) and perform a series of simple movements. The physiotherapist will assess your mobility by observing your range of movement and by gently feeling your spine, shoulders and muscles as you perform the movements. The initial assessment will probably last up to 45 minutes and subsequent treatment sessions will also typically last forty-five minutes.
It should be noted that Chartered Physiotherapists are trained to recognise when physiotherapy won't help and when to refer a patient to a doctor. Your Chartered Physiotherapist will not begin your treatment until they believe they fully understand your condition and what can be done to help.
Your treatment plan.
After diagnosing the cause of your condition the Physiotherapist will propose a treatment program which may consist of one or more of the following techniques:
- Mobilisation
- Manipulation
- Functional and Rehabilitative exercises
- Postural assessment, correction and advice
- Relaxation therapy
- Ultrasound and electrotherapy
- Massage
In the case of neck pain and back pain, manipulation can be an effective treatment, but it may not be the best option in every situation. After a full examination your Physiotherapist will discuss treatment options with you. In particular your physiotherapy will examine you carefully before manipulating your neck or back to see if other methods, such as mobilisation would be preferable.
You will also be given exercises to do at home and, in some cases, advice as to how to minimise any negative impact of your lifestyle on your condition. This 'homework' is a crucial part of your treatment and should not be ignored. The Physiotherapist is seeking to promote your body's ability to self-heal and the exercises are an important part of this process.
Most Physiotherapists expect to see considerable treatment benefit within two to six sessions, although sometimes a single treatment is sufficient. Your Physiotherapist should make you feel at ease and communicate effectively with you and you should ask questions at anytime during your consultation if you are unsure.
Symptoms commonly treated by Physiotherapists
Physiotherapy is well-known for treatment of back pain in general. However, Physiotherapists routinely treat, with excellent results, conditions such as neck pain, migraine and headache, frozen and stiff shoulders, repetitive strain injuries, knee and hip problems, arthritic pain and stiffness, disc injuries, trapped nerves, cramps, leg pain and sciatica, ankle and foot problems, whiplash injuries, tennis elbow, wrist pain, and various types of soft-tissue injury. Not infrequently such conditions may be caused by or related to sports injuries.
Some of the most common symptoms treated by Physiotherapists are outlined below:
- Tight or aching shoulders
- Headaches at the base of your skull or top of your spine
- Neck stiffness
- Acute immobilising lower back pain
- Sciatica and trapped nerves
- Pain and stiffness in the shoulder preventing a full range of movement
- Whiplash
- Arm and Hand Pain sometimes accompanied by tingling or numbness
Tight or aching shoulders
Common Causes
- Sedentary working environment
- Poor posture maintained for long periods of time. Common examples are driving and operating machinery or computers
- Tightness or aching is typically caused by a build-up of lactic acid, resulting in hardness and pain in the affected muscles
Treatments
- Take frequent breaks to avoid the onset of the condition in the first place and perform exercises such as shrugging your shoulders and stretching your shoulder blades back to meet each other
- Analyse your posture to ensure you are sitting as upright as possible (i.e., not sitting forward in a "hunched" position) - if necessary seeking assistance from an occupational health professional or specialist retailer
- If your muscles become too hard you will need Physiotherapy to stimulate blood flow in the hardened veins of the shoulder muscles and allow deposits of lactic acid to drain away naturally
- Physiotherapy is recommended if movement remains restricted after a few days or if you suffer from bouts of stiffness on a regular or not infrequent basis
Headaches at the base of your skull or top of your spine
Common Causes
- Broadly similar to those described above for tight or aching shoulders
Treatments
- Avoidance of the common causes and exercises to promote blood flow to the sub-occipital muscles at the base of the skull
- Analyse your posture to ensure you are sitting as upright as possible (i.e., not sitting forward in a "hunched" position) - if necessary seeking assistance from an occupational health professional or specialist retailer
- Physiotherapy is recommended if movement remains restricted after a few days or if you suffer from bouts of stiffness on a regular or not infrequent basis
Neck Stiffness
Common Causes
- Sudden "locking" of the neck due to muscle spasm. This can occur for an infinite variety of reasons such as, lying too long in one position, violently sneezing or making an unusual movement involving the head or neck muscles
- Degeneration in C5 and C6 spinal discs (typically in older patients)
Treatments
- Application of an ice-pack in the acute initial phase can help. Later a heat-pack or hot water bottle should provide relief
- A GP will frequently prescribe you pain-killers and/or anti-inflammatories such as ibroprofen Physiotherapy is recommended if movement remains restricted after a few days or if you suffer from bouts of stiffness on a regular or not infrequent basis
Acute immobilising lower back pain
Common Causes
- Can be set-off by almost any bending movement such as picking up a dropped pen, turning to reach something, or the jolt from missing a step
- The root cause is typically an underlying disc instability or local spinal joint irritation which is inadvertently triggered by an unexpected event
- Pain and lack of mobility is caused by muscle spasm which are part of your body's defence mechanism
Treatments
- An ice-pack may help at the acute stage
- Anti-inflammatory drugs and pain-killers will probably be prescribed by your GP
- Once the spasm begins to ease, physiotherapy massage and manipulation will typically be very helpful in restoring mobility and reducing pain more quickly than the bed-rest often recommended by GPs
- The exercise programmes your Physiotherapist recommends are important to ensuring that the underlying instability which caused the problem is addressed and the injury does not recur
Sciatica and trapped nerves
Common Causes
- Sciatic nerves run down the spine from the backside, behind the thigh, the lower leg and into the foot and toes. Pressure on the nerve from a bulging disc can cause pain all the way along the nerve pathway or just part of the way along it
- Sciatica can come on gradually or develop suddenly following a particular event
Treatments
- Doctors typically recommend some or all of bed-rest, pain-killer, muscle relaxants and anti-inflammatory drugs. In extreme case surgery may be necessary if the bulging disc does not naturally subside
- The benefits of physiotherapy in promoting the body's self-healing capabilities are particularly useful - especially in encouraging exercise as a means of managing the presence and/or intensity of sciatic pain
Pain and stiffness in the shoulder preventing a full range of movement
Common Causes
- Sedentary working environments
- Poor posture maintained for long periods of time. Common examples are driving and operating machinery or computers
- The condition can be caused by tendonitis - i.e., inflammation - of one of the four tendons in the shoulder joint or inflammation of the bursa in the same area
Treatments
- Physiotherapy is frequently successful with this condition, with techniques often focussing not just on the shoulder, but also on the spine and ribcage
- A local injection of steroids or surgery is sometimes required, but not before fully investigating physiotherapy treatment options
Whiplash
Common Causes
- A stiff neck (frequently accompanied by a headache) caused by a violent extension of the neck, e.g., in a car accident or falling forward face-first
- Problems often manifest in the neck but can also appear in the upper-back and even in the lumbar spine region
Treatments
- If the condition does not swiftly remedy itself, then physiotherapy treatment is highly appropriate for speeding the body towards recovery
- Untreated, whiplash symptoms can persist for months or years causing chronic pain
Hand Pain
Common Causes
- Hand problems arise due to joints failing to function properly. The most common problems are: Carpal tunnel syndrome which is caused by a compression of the median nerve in the wrist
- Although there may not be any obvious cause it is frequently associated with rheumatoid arthritis and osteoarthritis
- Tendoninitis where the tendon linings across the hand and wrist are inflamed often by overuse type injuries
Treatments
- Physiotherapy techniques are effective to help improve the flexibility of hand movement
